In recent years there have been developed a number of instruments for placing fasteners in a circular configuration or in a plurality of circular configurations for use in reconnecting severed vessels or hollow organs. These devices are used to perform anastomosis; that is, join the cut end of hollow organs or vessels. Whenever the term "vessel" is used throughout this specification it means a hollow tubular organ; such as intestine, esophagus, blood vessel and the like.
Generally speaking, these intraluminal stapling devices comprise a centrally extending longitudinal member on which there is mounted a circular anvil member and a circular staple holding member. These members are separated from one another but are movable along the centrally located member so that they may be placed adjacent each other. To join a severed vessel, one end of the severed vessel is pulled over the anvil portion of the intraluminal device. A purse string suture; that is, a loosely placed suture, is placed around the cut end of the vessel in a manner to act as a purse string so that it may be pulled tight and pulls the loose end of the vessel down tightly about the centrally located member with portions of the vessel or the tissue then disposed directly underneath the anvil of the instrument. The opposite end of the vessel to be joined is pulled over the stapling portion of the instrument in a similar manner. It is also pulled down utilizing the purse string suture so that it is tied against the centrally located member of the instrument and the tissue underlies the staple applying member. At this point, the staple and anvil are moved towards one another to provide a correct gap between the tissues to be joined. Once that correct gap is obtained, the staples are fired, joining the tissues. Staples may be disposed in various arrays, although usually a pair of concentric circles with the staples offset in adjacent circles is used. Once the staples have been fired, a circular knife, which has a smaller diameter than the smallest array of staples that have been fired, severs the tissue inside the staple line and outside the purse string sutures. The anvil and staple holder may then be backed off or separated and the instrument carefully removed from the rejoined vessel An example of such an instrument is more fully disclosed in U.S. Pat. No. 4,351,466, issued Sept. 28, 1982.
As can be appreciated from the above description, a critical point in the procedure is to be sure the tissue is positioned up against the central longitudinal extending member of the instrument so that the tissue underlies those portions of the instrument which are used to join the tissue together. Depending on the location of the vessel, size of the vessel, etc., it is often very difficult, if not virtually impossible, to place a suitable purse string suture in a manner so as to insure good juxtaposition of the vessels. This is especially true in low colon anastamosis where it may be very difficult to place the purse string suture on the distal end of the vessel.
It is an object of the present invention to provide a simple means for gathering and tying a vessel in a desired location. It is a further object of the present invention to provide a means for easily securing the distal end of a vessel to provide for anastamosis of that vessel. It is a further object of the present invention to provide means which can readily position a vessel to be disected in a desired manner even in the most difficult positions in which to work.